Objective To develop-the rat model of diffuse brain injury(DBI)and to observe the pathophysio logical alteration of the rats after.traumatic injury.Methods A modified Marmarou's traumatic device W88 used to establish the animal model of diffuse brain injury with different degree through changing the impact condition that was applied on the rat brain(including 80cm 450g,120 cm 450g and 180cm 400g);the animal model was evaluated by observing the variations of nervous system signs,vital signs,sensorimotor function,and morphological changes of brain tissue in the rats that have received different impacts.Results The significant changes in nervous system signs,vital signs and sensorimotor function had been observed in all rats that were subjected to the different impact.The pathologic changcs of DBI in rats brain could he found in all groups.Moreover,this characteristic changes would have became more significant following the traumatic iaiury when the impact energy was increased.Conclusion The rat model of graded diffuse brain injury have been developed successfully.The moderate impact(120cm 450g)could produce low animal death rate and result in obvious pathologieal alterations in the injured rat brain.This impact condition would be suitable to be used in the study about DBI.

Objective To observe the time of occurance,morphologic characteristics,and development of the retinal neurons' apoptosis of the early phase indiabetic rats. Design Experimental study. Participants Sprague-Dawley (SD) rats. Methods In 36 male SD rats of 8-week old,18 were diabetic models induced by streptozotocin injection,and 18 normal ones as control. Each group were subdivided into 3 groups (each group,n=6),in which the rats were sacrificed at 4,8 and 12 weeks,respectively. The pathological change of the retina,and the retinal neurons ultrastructure were observed. Apoptosis of the retinal neurons was also examined by TdT-mediated dUTP nick end label (TUNEL) assay. Main Outcome Measures The pathological retinal structure,the ultrastructure of retinal neurons,and the apoptosis of the retinal neurons in each group. Results No obvious structural changes of retina were found pathologically in diabetic rats of 4-week and 8-week,comparing with age-matched control group. However decreased retinal ganglion cell number and thinner inner nuclear layer were observed in diabetic rats of 12 weeks. Apoptosis defined by electron microscope,including cell shrinkage,reduced cell volume,chromatin margination and nuclear shrinkage and collapse,was found in each subgroup of diabetic rats. Apoptosis in the retinal ganglion cells layer and the inner nuclear layer was dominant. The apoptosis of the retinal neurons by TUNEL assay occurred at 4 weeks after onset of diabetes,and the number of the apoptosis neurons increased at 8 and 12 weeks in diabetic rats,the apoptosis neurons mainly located in the retinal ganglion cells layer and the inner nuclear layer. Conclusion Apoptosis of the retinal neurons occurred at 4 weeks after onset of diabetes and the degree of the apoptosis was correlated with the process of disease in rat model.

Objective To detemine the effect of autografts of in-vitro cultured corneal limbal stem cells for treating pterygium. Methods A total of 11 cases (12 eyes) with pterygium were treated with autograft of in-vitro cultured corneal limbal stem cells and were followed-up for 6-15 months. Results During the follow-up pterygium recurred in 1 eye (8.33 %) . All of the grafts survived well and no immunological rejection or other complication occurred. Conclusion Autograft of in vitro cultured corneal limbal stem cells is an effective and valuable method to treat pterygium.

Objective To explore the values of various surgical techniques in the treatment of secondary hepatocarcinoma.Methods One hundred thirty-four patients with secondary hepatocarcinoma were respectively divided into three groups,hepatectomy(group Ⅰ), other surgical treatments(group Ⅱ) and chemotherapy or/and interventional therapy(group Ⅲ). Retrospective analysis was performed to all patients above mentioned.The three groups were compared each other for survival rate.Results The survival rate among three groups was significantly different.There was a higher survival rate in hepatectomy group.Conclusions Hepatectomy is the most effective method to cure secondary hepatocarcinoma.

Atherosclerosis is the important pathologic basis of coronary artery disease,cerebrovascular disease,peripheral arterial disease and other vascular diseases.Studies have shown that the atheromatous plaques occur mainly in regions of curvature,bifurcation,and branching of the artery,indicating that low flow shear stress is closely associated with the occurrence of atherosclerosis.Low flow shear stress involves in the induction of atherosclerosis through acting on mechanosensitive molecules in endothelial cell that transduce mechanical stimuli into chemical signals,activate the corresponding intracellular signaling pathways.This article reviews the relationship between low flow shear stress and atherosclerosis.

Objective To evaluate the performance of a prediction system built with LASSO regression model and Baidu search query data.Methods Based on a strategy using a combination of Bagging and multi-measure optimization method,this study proposed an ensemble LASSO regression model which had an obviously improved performance,and applied it to predict the epidemics of influenza in China.Results The results showed that the improved model had significantly smaller prediction error rates than that of the conventional LASSO regression model for influenza cases during the study period of 2011-2015.This study designed an open source R package,SparseLearner,which was conveniently used and further developed.Conclusion The combination of Bagging and multi-measure optimization method is an efficient strategy to improve the performance of LASSO regression model.The proposed ensemble LASSO regression model in this study can be applied for the prediction of infectious diseases epidemics.

Objective To investigate pathogen bacteria distribution and clinical analysis of ventilator-associated pneumonia in infants and young children with congenital heart disease after surgery for guiding the rational clinical use of antimicrobial drugs.Methods The clinical data of ventilator-associated pneumonia in infants and young children with congenital heart disease after surgery were retrospectively analyzed for microbiologically documented infection.Bacterial identification was performed in an automatic VITEK2Jr expression system and antimicrobial susceptibility testing by Kirby2Bauer method.The results of antimicrobial susceptibility testing were performed in WHONET 5.0 system software.Results There were 16 strains of pathogenic bacteria in 2010,Gram-negative bacteria 9 stains (Klebsiella pneumoniae 18.75％,Acinetobacter baummannii 12.5％),gram positive coccus 6strains (Streptococcus 18.75％),Fungi 1 strain.There were 32 strains of pathogenic bacteria in 2011,Gram-negative bacteria 24 stains (Acinetobacter baummannii 31.25％,Klebsiella pneumoniae 25％,Pseudomonas aeruginosa 6.25％),gram positive coccus 8 strains (Enterococcus 12.5％,Streptococcus 6.25％).There were 42 strains of pathogenic bacteria in 2012,Gram-negative bacteria 38 stains (Acinetobacter baummannii 26.19％,Klebsiella pneumoniae33.33％,Pseudomonas aeruginosa 21.42％),gram positive coccus 4 strains (Enterococcus 4.76％).Acinetobacter baummannii remained highly sensitive to Amikacin and Levofloxacin,highly resistant to Meropenem,Imipenem,Klebsiella pneumonia remained highly sensitive to Amikacin and Levofloxacin,highly resistant to Cefoperazone/Sulbactam,Meropenem,Imipenem,trimethoprim-sulfamethoxazole,Ciprofloxacin.Pseudomonas aeruginosa only remained sensitive to Levofloxacin and Piperacillin/Tazobactam.Gram-positive cooci proportion in pathogenic bacteria decreased year by year,Streptococcus and Enterococcus had major proportion in Gram-positive cooci,Staphylococci decreased,There was no Staphylococcus,Enterococcus and Staphylococci resistant to vancomycin.Conclusions Gram-negative bacteria was the major pathogenic bacteria in ventilator-associated pneumonia with congenital heart disease postoperative infants and young children,Acinetobacter baummannii Klebsiella pneumoniaeand Pseudomonas aeruginosa had major proportion in gram-negative bacteria and drug resistance increased.Rational use of antibacterials was very important to reduce drug resistant strains.

Objective To investigate the changes of peripheral blood lymphocyte function in the children patients with acute phase of Henoch-Schonlein purpura(HSP),and to explore its significance in the diagnosis and therapy of HSP.Methods The peripheral blood lymphocytes subsets CD3+,CD4+,CD8+,CD4+/CD8+,CD19+ and NK cells(CD16++ CD56+) were detected in 51 children patients with acute phase of HSP and 40 children undergoing physical examination by flow cytometry(FCM Results Compared with the control group,the counts of peripheral blood CD4+,CD4+/ CD8+and NK cells CD16++ CD56+) in the acute stage of the HSP group were significantly decreased(P<0.01),while the proportions of CD8+ and CD19+cells were significantly increased(P<0.05,P<0.01).Conclusion The immunity dysfunction exists in the children patients with acute phase of HSP.The peripheral blood lymphocyte function detection has an important significance for the early diagnosis and treatment of HSP.

Objective To explore the application of evaluation of measurement uncertainty in routine coagulation assays based on the data of internal quality control (IQC) and results of external quality assessment (EQA) .Methods Data of clinical coagulation assays of clinical laboratory of Xiangyang city hospital were collected ,Which came from six months of IQC and 3 times of EQA of ministry of health clinical laboratory center from 2012 to 2013 .The combined and expanded uncertainties of 3 measurements(PT , APTT and Fbg) were evaluated according to CNAS top-downapproach .Results When PT were in 12 .72 s and 21 .04 s ,its ex-panded uncertainty were 1 .06 s and 1 .96 s ,and APTT in 36 .6 s and 50 .6 s were 2 .59 s and 5 .30 s ,and Fbg in 3 .32 g/L was 0 .30 g/L .Conclusion Evaluation of measurement uncertainty by using internal quality control data and EQA results for routine coagula-tion detection index is economical and practical and acceptable way ,with good clinical practice .

The situational teaching of the course of introduction to medical humanities has some problems, such as low participation, poor communication, and lack of humanities thought. By reading text and creating text, narrative medicine can make students deeply participate in the scene, provide an intro-spective opportunity of being close to the patients, and make students better redefine the story of the other so as to be able to help patients to take a positive view of the disease. Therefore, by using the method of reading text and creating text of narrative medicine, this paper has studied the “4+3” situational teaching model reform of the course of “introduction to medical humanities”, analyzed the present situation and achievements and pointed out that the teaching should pay attention to the key elements, which is “to build a correct value view of medical humanistic, strengthen the emotional education of humanistic care, as well as culture humanistic knowledge and culture humanistic ability”, and it has also put forward some sugges-tions on improving the teaching level of“Introduction to medical humanities”in the future.